Should I take medicine if my uric acid level is simply elevated?

Tongling Traditional Chinese Medicine Hospital

At various gatherings, the world of food is "beautiful and dazzling", and while wandering in it, gout will quietly come. Data show that among patients with asymptomatic hyperuricemia, the annual incidence of gout is 4.9% when blood uric acid>540μmol/L. Gout is gradually becoming younger, which is related to lifestyle and dietary structure. In particular, young people have a special liking for fat house happy water, milk tea, etc.; hot pot alone is not enough, and they have to take soup to sew; staying up late for a long time, which increases the burden on the kidneys, then the chance of being infected is greatly increased. Therefore, some people lament that "the boomerang of indulgent life will eventually hit themselves."

Hyperuricemia and gout have become one of the common chronic diseases in my country, and have become the second largest chronic metabolic disease after diabetes. Studies have shown that they are closely related to the occurrence and development of various cardiovascular diseases. The treatment of hyperuricemia and gout is a comprehensive management with the core of improving lifestyle, controlling symptoms, reducing complications, and improving the quality of life as the goal.

Uric acid-lowering therapy for patients with asymptomatic hyperuricemia

1) Blood uric acid level ≥540μmol/L; 2) Blood uric acid level ≥480μmol/L, and one of the following complications: hypertension, abnormal lipid metabolism, diabetes, obesity, stroke, coronary heart disease, heart failure, uric acid nephrolithiasis, renal impairment (≥CKD stage 2), all require uric acid-lowering drug treatment. For persistent hyperuricemia, Chinese herbal tea can be used to strengthen the spleen and eliminate dampness according to the physical constitution, and uric acid-lowering drugs can be added when necessary. For gout patients who have already developed joint pain, ice compresses, timely rest, reduce weight bearing, and seek medical treatment in time to develop a comprehensive and long-term treatment plan.

The starting point and goal of uric acid lowering for gout patients: 1) Blood uric acid level ≥480umol/, no complications, start uric acid lowering treatment: it is recommended to control blood uric acid at 360umol/L; 2) Blood uric acid level ≥420umol/, one of the following complications, start uric acid lowering treatment: number of gout attacks ≥2 years, tophi, chronic gouty arthritis, kidney stones, chronic kidney disease, hypertension, dyslipidemia, diabetes, stroke, heart failure, etc.

Preventing gout recurrence

● Adjust your eating habits: Avoid eating high-purine foods (such as animal offal, seafood, red meat, etc.), eat more vegetables, fruits and low-fat foods. At the same time, maintain adequate water intake to help excrete uric acid from the body.

● Maintain good living habits: avoid staying up late, drinking and overwork. Do appropriate physical exercise to strengthen your body and improve blood circulation.

● Control your weight: Being overweight and obese will increase the production of uric acid and reduce its excretion, so maintaining a healthy weight is an important measure to prevent gout.

●Regular check-ups: People with a family history of gout or other high-risk factors should undergo regular blood uric acid tests and liver and kidney function tests. If a problem is found, seek medical treatment in a timely manner.

●Keep warm: When the joints are exposed to cold, local blood vessels contract, which can cause local deposition of substances such as urate, leading to acute gout attacks.

●Moderate exercise: For gout patients, it is recommended to control weight, exercise regularly and moderately, and avoid excessive violence. Avoid injuries during exercise, keep joints warm, and exercise for half an hour at a time (total exercise time per week > 150 minutes is appropriate). When sweating a lot, you should replenish water in time, otherwise it may cause the uric acid concentration in the blood to rise and gout may occur.

Traditional Chinese medicine has long recognized gout. The Complete Works of Jingyue states: "If it is caused from within, it is caused by excessive consumption of fats and sweets, excessive consumption of alcoholic beverages, or excessive consumption of cheese, dampness and heat, which causes heat to accumulate in the lower part of the body and flow into the feet and shins, causing swelling and pain day by day." Traditional Chinese medicine advocates dialectical conditioning through oral or external application of Chinese medicine (Bitongsan) for different body constitutions. For example, herbs such as Scutellaria baicalensis, Alisma orientalis, and Plantago asiatica can be used to clear away heat and dampness; herbs such as Angelica sinensis, Ligusticum chuanxiong, and Safflower can be used to promote blood circulation and remove blood stasis. At the same time, for some weak body constitutions, moxibustion and cupping can be used to warm the yang and strengthen the body to expel evil. In short, it is easy to know but difficult to do; intermittent self-discipline is easy, but continuous practice is difficult." Drug treatment is used when non-drug interventions are ineffective for hyperuricemia and gout. The treatment plan needs to be individualized, stratified, up to standard, and managed over a long period of time, and the dose should be adjusted gradually to avoid excessive fluctuations in blood uric acid levels in the short term that may induce acute gout attacks.